Document Detail


The asymmetric vascular stent: efficacy in a rabbit aneurysm model.
MedLine Citation:
PMID:  19131663     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Development of hemodynamic modifying devices to treat intracranial aneurysms is an active area of research. The asymmetrical vascular stent (AVS), a stent containing a low-porosity patch, is such device. We evaluate AVS efficacy in an in vivo intracranial aneurysm model.
METHODS: We created 24 elastase rabbit model aneurysms: 13 treated with the AVS, 5 treated with standard coronary stents, and 6 untreated controls. Four weeks after treatment, aneurysms underwent follow-up angiography, cone-beam micro-CT, histological evaluation, and selective electron microscopy scanning.
RESULTS: Four rabbits died early in the study: 3 during AVS treatment and 1 control (secondary to intraprocedural vessel injury and an unrelated tumor, respectively). AVS-treated aneurysms exhibited very weak or no aneurysm flow immediately after treatment and no flow in all aneurysms at follow-up. Standard stent-treated aneurysms showed flow both after treatment (5/5) and at follow-up (3/5). All control aneurysms remained patent during the study. Micro-CT scans showed: 9 of 9 scanned AVS aneurysms were occluded, 6 of 9 AVS were ideally placed, and 3 of 9 low-porosity region partially covered the aneurysm neck; standard stent-treated aneurysms were 1 of 5 occluded, 2 of 5 patent, and 2 of 5 partially patent. Histology results demonstrated: for AVS-treated aneurysms, advanced thrombus organization in the (9/9); for standard stent-treated aneurysms, (1/4) no thrombus, (2/4) partially thrombosed, and (1/4) fully thrombosed; for control aneurysms (4/4), no thrombus.
CONCLUSIONS: The use of AVS shows promise as a viable new therapeutic in intracranial aneurysm treatment. These data encourage further investigation and provide substantial support to the AVS concept.
Authors:
Ciprian N Ionita; Ann M Paciorek; Andreea Dohatcu; Kenneth R Hoffmann; Daniel R Bednarek; John Kolega; Elad I Levy; L Nelson Hopkins; Stephen Rudin; J Duffy Mocco
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2009-01-08
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  40     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-02-24     Completed Date:  2009-03-20     Revised Date:  2014-09-20    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  959-65     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Animals
Cerebral Angiography
Cerebral Arteries / pathology
Female
Intracranial Aneurysm / pathology,  therapy*
Male
Microscopy, Electron, Scanning
Porosity
Rabbits
Stents*
Thrombosis / pathology
Tomography, X-Ray Computed
Grant Support
ID/Acronym/Agency:
R01 EB002873/EB/NIBIB NIH HHS; R01 EB002873-01/EB/NIBIB NIH HHS; R01 EB002873-02/EB/NIBIB NIH HHS; R01 EB002873-03/EB/NIBIB NIH HHS; R01 EB002873-04/EB/NIBIB NIH HHS; R01 EB002873-05/EB/NIBIB NIH HHS; R01 NS038746/NS/NINDS NIH HHS; R01 NS038746-01/NS/NINDS NIH HHS; R01 NS038746-02/NS/NINDS NIH HHS; R01 NS038746-03/NS/NINDS NIH HHS; R01 NS043924/NS/NINDS NIH HHS; R01 NS043924-01A2/NS/NINDS NIH HHS; R01 NS043924-02/NS/NINDS NIH HHS; R01 NS043924-03/NS/NINDS NIH HHS; R01 NS043924-04/NS/NINDS NIH HHS; R01EB002873/EB/NIBIB NIH HHS; R01NS43924/NS/NINDS NIH HHS
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